Prénom du contact principal

Nom de famille du contact principal

Téléphone primaire

Adresse

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Mot de passe:

Someone who refers you receives special awards. If you are new to CYC, please indicate who referred you to us.

Please detail special circumstances which may not be reflected in your financial statements

**Buddy request** If your child has a friend(s) of the same age (grades 1-3, 4-6, or 7-9) and same sex attending camp during the same session, they may request to room in the same cabin. Please list. Must use names, do not request general groups (ie- everyone from X church)